Viewpoint: Why hospitals should invest in clinician-led quality improvement


Hospitals can instill more meaning in clinicians' work and achieve better quality outcomes by investing in clinician-led improvement efforts, one physician leader wrote in an op-ed for STAT.

Lara Goitein, MD, serves as medical director of clinician-directed performance improvement at Santa Fe, N.M.-based Christus St. Vincent Regional Medical Center.

A few years after Dr. Goitein joined Christus St. Vincent in 2011, the hospital rolled out a clinician-directed performance improvement program that offers front-line clinicians paid protected time to work on quality improvement projects. Each service line designates a "clinician dyad" to oversee improvement projects, which usually comprises a physician and nurse who don't practice full time.

In the program's first four years, clinician dyads finished more than 40 improvement projects at a 92 percent success rate. Over that same period, the hospital's CMS star rating jumped from two stars to five.

The projects also led to lower rates of hospital-acquired infections, adverse drug events and sepsis deaths, while boosting clinician morale, according to Dr. Goitein.

"Any hospital — not just large, affluent or academic medical centers — can make meaningful investments in clinician-led quality improvement," she wrote. "The greatest challenge is to make the leap of faith in which the organization commits to truly supporting its clinicians' quality priorities."

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